Abstract

Introduction: Immuno-allergic reactions to antituberculous treatment occur in 4 to 5% of cases and cause serious problem in the management of tuberculosis especially when due to major drug such as rifampicin.

Aim of the study: To describe different allergic reactions to rifampicin, the means of their confirmation and their management.

Methods: Retrospective study including all patients treated for tuberculosis (TB) and who developed allergic reactions to rifampicin between January 2000 and December 2009.

Results: Twelve (12) patients were included with mean age of 42 years. Mean delay of symptoms was 30 days after antituberculous treatment onset. Cutaneous reactions were noted in 11 patients, fever in 5 patients and anaphylactic reactions in 2 patients. Two patients had thrombocytopenia with hemorrhagic syndrome and 4 had hepatic cytolysis. Rifampicin responsibility was admitted after interruption of all the treatment and reintroduction one by one in 10 patients. In 2 cases the occurrence of thrombocytopenia after interrupted use of rifampicin and normalization of platelet level when rifampicin was stopped, allowed diagnosis. In 6 cases allergic reactions to rifampicin was associated to other antituberculous drug allergy. Rapid oral desensitization to rifampicin was successfully conducted in 4 patients. In 8 patients, rifampicin was definitively stopped, substituted by other antituberculous drug in two patients.

Conclusion: Severe allergic reactions to rifampicin are rare but can cause serious problem in tuberculosis management. In these cases rapid oral desensitization represent an interesting alternative.